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The Department of Psychiatry at the University of California, San Diego (UCSD) School of Medicine is currently running three clinical trials for patients with social anxiety disorder, under the direction of Murray Stein, M.D., M.P.H., professor of psychiatry and family & preventive medicine and expert in the treatment of this common, yet sometimes emotionally crippling, anxiety disorder.
Social anxiety disorder, also known as social phobia, is not about garden-variety shyness, according to psychiatrists. The condition has been recognized as a psychiatric disorder since 1980. According to Stein, at least one in 20 individuals suffers from social anxiety disorder, which can impact a person’s choice of careers or success in relationships, school and jobs. Because people with social anxiety disorder have a tendency to avoid situations that cause intense anxiety or distress, they have difficulty attending school, engaging in sports, going on a date, or interacting with others at work.
Untreated, social phobia can lead to serious problems. Stein and colleagues have found that almost six in ten individuals with social anxiety disorder are clinically depressed, and one in four has recently been treated for substance abuse. Researchers speculate that perhaps the isolation brought on by social anxiety disorder contributes to these other disorders.
The American Psychiatric Association defines social anxiety disorder as “a marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing…”
When faced with a situation where others might observe them, patients with social anxiety disorder experience extreme anxiety,” said Stein. “This could take form of a panic attack, an acute episode of anxiety with symptoms such as a racing heart, skipped heartbeats, shaking, sweating and blushing.”
Stein and his colleagues are currently directing three clinical trials that could lead to better understanding of social phobia, and perhaps better treatment for the disease.
The first, SAPIENT (Social Anxiety Pharmactherapy ImprovemENT), funded by the National Institutes of Health, is a five-year pharmacotherapy study to find out why SSRIs (selective serotonin reuptake inhibitors) – a class of antidepressant drugs including Prozac, Zoloft, Paxil, and Effexor – work in treating social phobia in some patients, but not in others. This trial will also evaluate whether a patient’s genetic makeup can predict if they will respond to SSRI treatment. An extension to the study evaluates the usefulness of self-help therapy to maintain long-term benefits of treatment.
The second study has a functional magnetic imaging (fMRI) component, which will be conducted by UCSD professor of psychiatry Martin Paulus, M.D., at UCSD’s Keck Center, home to one of the largest fMRIs in the western United States. The fMRI measures oxygenated blood flow to areas of the brain, tracking brain activity. This clinical study will be a randomized, control trial with a new class of medications called NK1 antagonists, which are being tested for their anti-anxiety properties.
The third study will look at whether a drug currently on the market for treating attention deficit hyperactivity disorders (ADHD) by working on the body’s noradrenaline system, is also useful for treating social anxiety disorder.
Patients with questions or who may be interested in participating in an appropriate clinical trial should contact the investigators at 1-877-UCSD-SHY.
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